From all points of the political compass, from widely different groups, have come indignant outcries against the trade in human organs from live vendors. Opponents contend that such practices constitute a morally outrageous and gross exploitation of the poor, inherently coercive and obviously intolerable in any civilized society. This article examines the arguments typically offered in defense of these claims and finds serious problems with all of them. The prohibition of organ sales is derived not from the principles and argument (...) usually invoked in support of prohibition, but rather, from strong feelings of repugnance which exert an invisible but powerful influence on the debate, distorting the arguments [and working] to the detriment of the [very] people most in need of protection. (shrink)

Some are concerned about the possibility that offering money for research participation can constitute coercion or undue influence capable of distorting the judgment of potential research subjects and compromising the voluntariness of their informed consent. The author recognizes that more often than not there are multiple influences leading to decisions, including decisions about research participation. The concept of undue influence is explored, as well as the question of whether or not there is something uniquely distorting about money as opposed to (...) a chance for treatment or medical care. An amount of money that is not excessive and is calculated on the basis of time or contribution may, rather than constitute an undue inducement, be an indication of respect for the time and contribution that research subjects make. (shrink)

This article focuses on ethical issues surrounding the selling and buying of human organs. The author argues that most people who sell their organs in India do so in order to pay already existing debts. The transaction is only temporarily an exchange of “life for life,” and most “donors” are back in debt soon after the operation. The author discusses the flexible ethics that reduce reality to dyadic transactions and the purgatorial ethics that collapse real and imaginary exploitation in the (...) service of complex interests. He also offers a sophisticated discussion of the ethics of publicity and public ethics. He emphasizes the lack of factual information, intentional manipulation of information, and the dissemination of kidney panics and kidney scandals, especially by the new developing bioauthorities and bioethical brokers. (shrink)

Little attention has been given in medical ethics literature to issues relating to the truthfulness of patients. Beginning with an actual medical case, this paper first explores truth-telling by doctors and patients as related to two prominent models of the physician-patient relationship. Utilizing this discussion and the literature on the truthfulness and accuracy of the information patients convey to doctors, these models are then critically assessed. It is argued that the patient agency (patient autonomy or contractual) model is inherently and (...) seriously flawed in numerous circumstances, even those involving informed and competent adult patients. (shrink)